Reprinted from the Journal of Nervous and Mental Disease, November, 1893. 
A Study of the Temperature in Twenty-five 
Cases of General Paralysis of the Insane 
BY 
FREDERICK PETERSON,'M.D. 
New York. Reprinted from the Journal of Nervous and Mental Disease, November, 1893. 
A STUDY OF THE TEMPERATURE IN TWENTY- 
FIVE CASES OF GENERAL PARALYSIS OF 
THE INSANE. 
By FREDERICK PETERSON, M.D., 
Formerly First Assistant Physician at the Hudson River State Hospital for the Insane; 
Professor of Nervous Diseases in the University of Vermont; Instructor in Ner- 
vous and Mental Diseases, College of Physicians and Surgeons, New York. 
AND 
CHARLES H. LANGDON, M.D., 
Second Assistant Physician, Hudson River Hospital for the Insane. 
IT has long been a matter noted by alienists that there 
are great oscillations of temperature in general par- 
etics. Diurnal oscillations, variations from day to 
day, asymmetrical axillary temperature and general sub- 
normal or hyper-normal temperature have been ascribed 
to these cases by some authors. Thus Clouston, in Tuke's 
" Dictionary of Psychological Medicine," states that the 
general temperature is highest in general paresis, of all 
insanities. Kiernan (Journal Nerv. and Ment. Dis., 
April, 1878, article by A. E. Macdonald, Am. Jour. Insan- 
ity, April, 1877, and also in a recent article on the diag- 
nosis of different forms of general paresis) claims that a 
prominent clinical feature of such cases is the tempera- 
ture ; that it is usually subnormal, with extraordinary 
daily variations (agreeing with Rottenbiller, whom he 
quotes), and that there is asymmetry of the axillary tem- 
perature. Rottenbiller <Allg. Zeitschr. f. Psych., 1885) 
gives similar testimony and cites instances of remarkable 
daily oscillations, in one case of nearly six degrees. 
Kroemer (Halle) in the Allg. Zeitschr. f. Psych., xxxvi, 2te 
and jte Heft, in an analysis of observations in thirty-four 
cases, claims that the average general bodily temperature 
in general paresis is lower than normal ; that in the last 
stages there are great variations daily ; and that paralytic 
accidents are accompanied by a rise of temperature. 2 
PAR AL YSIS OF THE INSANE. 
It occurred to us that if these observations were cor- 
rect, it might be well worth while to study the matter 
more fully, in order, if possible, to throw some light upon 
the origin of such remarkable variations from the normal. 
Theoretically it seemed that the facts being what they 
are stated to be, and the pathological changes being 
chiefly of a cortical nature, there might be some relation 
between the morbid changes and certain supposed ther- 
mo-taxic centres in the cortex. These thermo-taxic cor- 
tical centres have been located chiefly in the anterior 
lobes of the brain in lower animals, about the cruciate 
and Sylvian fissures (Eulenburg and Landois, Isaac Ott, 
etc., vide "Modern Antipyretics," by Ott, 1892). The 
question is then, are the supposed variations of tempera- 
ture of general paresis explicable upon the grounds of a 
meningo-encephalitis affecting thermo-taxic cortical cen- 
tres ? 
The authorities quoted above would seem almost suffi- 
cient to establish as facts these temperature variations. 
At the same time we thought it most important to carry 
out thoroughly a series of observations upon a consider- 
able number of cases, thus enabling us to base any con- 
clusions we might reach upon wholly original facts. To 
this end we selected twenty-five suitable cases of general 
paresis from among the large numbers of such in the 
Hudson River State Hospital for the Insane, and in each 
case made careful thermometric observations every two 
hours for one week. In ten of the cases, additional obser- 
vations were made for the same length of time, every two 
to four hours, with thermometers in both axillae, in order 
to determine the question of axillary asymmetry. The 
temperatures were taken in the axilla, and with carefully 
selected thermometers of the most approved type. 
The following are the exact figures in all of these 
cases, each case being accompanied by a brief note of the 
clinical condition of the patient. 
Case I.-V. C.; age 46; male; married; clerk. Good 
habits. Born in New York. Duration of insanity five 
years. Has been confined to bed for the past three FREDERICK PETERSON. 
3 
months. Gait tottering and staggering. Is very trem- 
ulous. Both pupils are contracted, but r > 1. Knee-jerk 
absent on both sides. Articulation and deglutition 
difficult. Has had delusions of wealth and grandeur, 
but mind is now almost a complete blank. Is profound- 
ly demented. Is in the last stages of general paresis. 
Hours. 
ist day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
I P.M. 
99-4 
98.8 
97-8 
98.6 
98.4 
98.8 
98.4 
3 " 
99 
98.8 
98 
98.2 
98-4 
98 
98 
5 " 
98.8 
97-6 
98.2 
98.8 
98 
98.4 
98 
7 " 
98.8 
98.2 
97-8 
98. 2 
98-4 
98.4 
98 
9 " 
98.4 
98.2 
98.4 
98 
98 6 
98-4 
98.2 
ii " 
97-6 
98.2 
98 
97-6 
98.4 
98.2 
98.2 
i A.M. 
98 
98 
97-8 
97-8 
98.2 
98.2 
98 
3 " 
98 
97-8 
98.2 
97-8 
98 
98 
98.2 
5 " 
97.6 
97-8 
98 
97-2 
98 
98 
98 
7 " 
97-4 
97 4 
97-2 
97-4 
98 
97.6 
98 
9 " 
97-6 
97-6 
97 6 
97 4 
97-4 
98 2 
98.2 
ii " 
97-6 
97-4 
97-8 
97-8 
98.6 
98.2 
98.2 
Widest daily 
variation. 
2. 
i-4 
1.2 
1.6 
1.2 
1.2 
•4 
Case I.-V. C. The following observations were 
taken about six weeks after the proceeding ones; no 
very special change occurring in the patient's condition 
during this time. 
TABLE CONTRASTING BOTH AXILLARY TEMPERATURES. 
CASE I. 
Hours. 
ist day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day_ 
I 
P.M. 
R 98.4 
L 98.2 
3 
«< 
R 98.6 
R 98.2 
R 98.4 
R 98.2 
R 98.2 
R 98 
L98.4 
L 98.2 
L98.3 
L 98 
L 98 I 
L98 
5 
(( 
R 98.5 
L 98.8 
7 
c < 
R 98.8 
R 98.2 
R 98.2 
R 98.2 
R 98.2 
R 98 
L 99 
L 98.2 
L 98.4 
L 98.2 
L98 
L98 
9 
I ( 
R97.8 
L 97-9 
11 
<1 
R 98.2 
R97 9 
R 98 
R 97.6 
R97.8 
L 98.4 
L 97 
L 97 9 
L 97.6 
L 97-7 
i 
A.M. 
R 98.9 
L 98.6 
3 
4 4 
R 98.6 
R 98 6 
R 97 6 
R 97.4 
R 97.7 
L 98.4 
L 98.4 
L 97.9 
L 97.2 
L 97-7 
5 
R 97.8 
L97.6 
7 
4 i 
R 97.8 
R 98 6 
R97-8 
R 97.4 
R97.8. 
L 97.8 
L 98-2 
L 98 
L 97.2 
L 97.8 
9 
4 < 
R 98 
L 98 
ix 
< < 
R 98.4 
R 98 
R 98.4 
R 98.2 
R 98 
R97.S 
L 98 2 
L 98.2 
L 98.2 
L 98 
Iv 97-9 
L 97.8 
Widest axillary asymmetry 
= -9 
Average 
axillary asymmetry = .15 PARALYSIS O'F THE INSANE. 
4 
Case II.-I. B.; age 52; male; married; carpenter, 
born in Canada; intemperate habits. Duration of in- 
sanity nearly five years. Is in the last stages of general 
paresis. Is in bed; cannot stand. Is very tremulous. 
Knee-jerks slightly exaggerated on both sides, but 
more so on the left than on the right; pupils unequal 
1 > r. 
Hours. 
1st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
I P.M. 
99-2 
99-4 
98.8 
98.6 
98.8 
98-4 
98.8 
3 " 
98.8 
99-4 
99 
97-8 
98.8 
98.8 
98.6 
5 " 
98 8 
99-2 
98 8 
98 
99-6 
98.4 
98.6 
7 
98.6 
98.6 
99 4 
97-8 
99-6 
98 6 
99 4 
9 " 
98.8 
99 
98.6 
97-8 
98-4 
99-6 
98.2 
ii " 
98.4 
98.6 
98.6 
97-8 
99 
98 4 
99 
i A.M. 
98 4 
98-2 
98-4 
98 
98 2 
98-4 
98.6 
3 " 
98.6 
98-4 
98 
98 
98.2 
98 2 
99 
5 " 
98.2 
98.2 
98.2 
98 
98 
98.2 
98.6 
7 " 
98.6 
q8 8 
98 
97-8 
98 
98 
98.4 
9 " 
99 
98-4 
98.2 
97-8 
98 
98.6 
98 4 
II u 
99-2 
98.8 
98.8 
98 
97-8 
98.6 
98.6 
Widest daily 
variation. 
1. 
1.2 
i-4 
.8 
1.8 
1.6 
1.2 
Case II.-I. B. About two weeks after the preced- 
ing observations were taken, patient had paretic con- 
vulsions followed by paralysis of the right side. At 
that time the temperatures were R 102.8, L 102.4. 
About six weeks intervened between the preceding 
observations and the following. The patient is in bed 
and quite feeble. 
TABLE CONTRASTING BOTH AXILLARY TEMPERATURES. 
CASE II. 
Hours. ist day. 
2d day. 
3d day. 
4th day. 
5th day. 
*6th day. 
2 P.M. 
R IOI 
R 102 3 
R 102.8 
R 104 
L 103.8 
L IOO.6 
L 102 
L 102.2 
L 103.8 
R 103.4 
4 " 
R ioi.4 
L ioi 4 
6 " 
R 100.2 
R 101.4 
R 103.8 
R 103.8 
8 " 
L ioo 
R ioi.4 
L ioi.3 
L IOI .2 
L 103 
L 103.4 
IO " 
R ioi 
R 102.6 
R 102 2 
R 102.8 
L 100.9 
L 102.4 
I. 102 
L 102.7 
12 " 
R 100.6 
L 100.4 
2 A.M. 
R 100 
R 99.4 
R 100 2 
R 102.8 
L 99.7 
L 99 
L 100 
L 102.7 
4 " 
R 100 
L 99.8 
6 " 
R 99.8 
L 99 8 
R 99.8 
R 100.4 
R 102.6 
L 99.2 
L 100.2 
L 102.4 
8 " 
R 101.6 
L 101.1 FREDERICK PETERSON. 
5 
IO " 
R 100.4 
L 100 3 
R 101.8 
L 101.8 
R 102.4 
L 102 
R 100.8 
L 100.4 
R 103.7 
L 103.8 
12 " 
R 100.4 
L 100 2 
* Pneumonia developing, died in the evening of the sixth day. 
Widest axillary asymmetry = .8 
Average axillary asymmetry = . 24 
Case, III.-J. O. C.; age 50; male; single; farmer; 
temperate habits; born in New York. Hereditary his- 
tory unknown. Duration of insanity five years. Is now 
confined to his bed. Is in the very last stages of general 
paresis. Mind is now a complete blank, but has had 
delusions of the greatest wealth and exaltation. Pupils 
contracted, 1 > r. Knee-jerk absent on both sides. 
Hours. 
ist day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
I P.M. 
97 
97 4 
97-2 
96.8 
99.6 
98.2 
98.4 
3 " 
97-6 
97-2 
97.2 
97-2 
98 8 
98.6 
97-8 
5 " 
97 
97-2 
97 
97 2 
100.4 
99 
97.6 
7 " 
97-2 
97 2 
97-2 
98 
100 
98.8 
97-8 
9 " 
97-8 
96.8 
97 
97-8 
99 
98.6 
97-8 
ii " 
97-2 
96.8 
97 
97-4 
99 
98 2 
98 
I A.M. 
97 
96.8 
97 
97 2 
98.2 
98.2 
97-8 
3 " 
97.2 
96.8 
97 
97 2 
98 
98 
98 
5 " 
98 
96.8 
97-2 
97-2 
98 
98.2 
98.2 
7 " 
97-4 
97-2 
97 2 
96.8 
98.2 
98.4 
98.2 
9 " 
97-6 
97 
97 2 
97-2 
98-4 
98.4 
98.2 
I I 
97 4 
97-2 
97 
98.6 
98.6 
98.6 
98.4 
Widest daily 
variation. 
1. 
.6 
.2 
1.8 
2-4 
I. 
.8 
Twelve days after the above examination the patient died. 
Case IV.-A. F. L.; male ; age 39 ; single ; baker ; 
good habits ; born in New York. Duration of insanity 
about three years. Now in the advanced stages of gen- 
eral paresis. Articulation very difficult. Is hardly able 
to say a word intelligibly. Gait staggering. Past few 
months has been losing control of his sphincters. Is 
very demented but happy. Pupils unequal r > 1. Knee 
jerk greatly diminished on both sides, but is less dimin- 
ished on the right side than on the left side. 
Hours. 
1st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
1.30 P. M. 
98 
98 
•98.4 
97-4 
98.8 
98 
98.4 
3-3° " 
98 2 
97-8 
98 
98 
98.2 
9 -4 
98.6 
5-30 " 
98.2 
99.2 
97-6 
98.2 
IOO 
99 
98.4 
7-30 " 
98 
98.4 
97-8 
97-8 
98.4 
98.4 
98 
9-30 " 
98.2 
97-8 
97-6 
-97-8 
98.2 
98.2 
98.2 
u.30 " 
98 
97.6 
97-2 
97.8 
98.2 
98-4 
98.2 
1,30 A. M. 
98.2 
97.6 
97-2 
97-8 
97-8 
98.2 
98 
3-30 " 
98 
97-4 
97 2 
97 8 
97-8 
98.2 
98.2 
5-30 " 
98 
97 4 
97-2 
97-2 
97-6 
98 
98 
7.30 " 
97-4 
98.4 
97 
97-8 
97-8 
98.2 
98.2 
9.30 " 
97 8 
98.4 
97 8 
97-8 
97-8 
98.2 
98.4- 
u.30 " 
97 
98 
97-6 
98.4 
98 
98.2 
98.4 
-- 
- 
■ 
- 
Widest daily 
variation. 
1.2 
i 8 
I 4 
1.2 
2 4 
I. 
.6 6 
PAR AL YS1S OF THE INSANE. 
Case IV.-A. F. L. The following observations were 
taken about six weeks after the preceding ones, no 
very special change occurring in the patient's condition 
during this time. 
TABLE CONTRASTING BOTH AXILLARY TEMPERATURES. 
CASE IV. 
Hours. 
1st day. 
2d day. 
3d day. 
4th day. 5th day. 
6th day. 7th day. 
2 30 P.M. 
R 100 6 
R 98 2 
R98.3 
R 98 
R 99-3 
R 98.1 
4-30 " 
L 100.4 
R 100 4 
L 100.2 
L 98.2 
L 98.2 
L 97.8 
L 99 
L 98 
6.30 " 
R 100 4 
R 98.6 
R 98.8 
R 98 
R 98.2 
R 98 
8 30 " 
L 100.3 
R98.4 
L 98 6 
L 98.6 
L 9S.6 
L97 9 
L 98 
L 97.9 
10.30 " 
12.30 " 
R 100 
L 99 
R 99 
L 99 
R 98 
L 98 
R 98.4 
L 98.4 
R 97-3 
L 97 4 
R 98.4 
L 98 4 
2.30 A.M. 
4 30 " 
R 99.2 
L 99 
R 97.9 
L 97.6 
R 99 
L 97.8 
R 98.2 
L 98 
R 98.4 
L98.4 
R97.8 
R 97 8 
6 30 " 
8.30 " 
R 98 
L 97-6 
R 98 2 
L98 
R 98.2 
L 98.2 
R 98.2 
L98 
R 98.1 
L 98.2 
R97.8 
L 97-8 
10.30 " 
12 30 " 
R 98.8 
L 98 8 
R 99.8 
L99.6 
R 97.4 
L 97 4 
R 98 2 
L 98.2 
R 98.4 
L 98.3 
R 98.4 
L 98.3 
R 98 
L 98 
Widest axillary variation - I. 
Average axillary variation = . 13 
Case V.-W. L.; male ; age 42 ; married ; two chil- 
dren ; civil engineer ; temperate habits. Academic edu- 
cation. Duration of insanity three years. Has had de- 
lusions of the greatest wealth and exaltation, some of 
which he still has. For the past six months has been 
very much demented. Is filthy and destructive in habits. 
Gait somewhat staggering. Tongue, lips and fingers 
tremulous. Pupils unequal, r > 1. Knee-jerk more 
marked on the left side than on the right. 
Hours. 
1 st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
1-45 P M 
97-8 
98 
98 
97-8 
99 
98.2 
98-4 
3-45 " 
97-8 
98.2 
97-6 
98 
98 4 
98-4 
98.6 
5-45 " 
97-8 
98 4 
98.2 
98.4 
100 
98.6 
98.4 
7-45 " 
98.6 
98 
98.2 
98.2 
98.4 
98-4 
98.6 
9-45 " 
98.6 
98.6 
98 4 
98 
98.4 
98-4 
98.4 
H-45 " 
98-4 
98-4 
98-4 
98.4 
98.6 
98.2 
98-4 FREDERICK PETERSON. 
7 
1.45 A M. 
98.2 
98. 2 
98.2 
98-4 
9s-4 
98 
98 4 
3-45 " 
98 4 
98. 2 
98.2 
98 
98 2 
98.2 
98-4 
5-45 " 
97 2 
97-4 
98 
98 
97-8 
98 
98. 
7 45 " 
97-6 
98.6 
98 
97-8 
98 
98 
98.2 
9-45 " 
98.2 
98 
98.6 
99 
98 
98 
98.2 
11-45 " 
97.8 
978 
98 
98.2 
98 
98-4 
98.4 
Widest daily 
variation. 
1.4 
1 2 
1. 
1 2 
2 2 
.6 
.6 
Case V.-W. L. The following observations were 
taken about six weeks after the preceding ones, no very 
special change occurring in the patient's condition dur- 
ing this time. 
TABLE CONTRASTING BOTH AXILLARY TEMPERATURES. 
CASE V. 
Hours. 
1st day. £ 2d day. 
" 3d day. 
4th day. 
5th day. 
6th day. 
7th day 
2.50 P.M. 
R 98.8 
R 98.2 
R 98.4 
R 99.2 
R 98.6 
R 99.6 
4-50 
L 98.4 
R 98.8 
L 98.7 
L98 4 
L 98.2 
L 99-4 
L 98.5 
99-4 
6.50 
R 99.6 
R 99 6 
R 98.8 
R 100 
R 100 2 
R 99.4 
8.50 
L 99 
R 98.7 
L 98.5 
L 99-5 
L 99 
L 97-6 
L 100 
L 99.2 
10.50 
12.50 
R 98.6 
L 98.5 
R 99 
L 98.8 
R 98.4 
L 98.6 
R 98.6 
L 98.4 
R 99 6 
L 99.2 
R 98.7 
L 98.5 
2.50 A. M. 
4 50 
R 97.9 
L 98 
R 97.2 
L 97.6 
R 98.4 
L 98.4 
R 97.8 
L 97-9 
R 98.4 
L 98 5 
R 98.4 
L 98.4 
6.50 
8 50 
R97.8 
L97 8 
R 98 
L 97.8 
R 98.6 
L 98.6 
R 98 
L 98 
R 98 
L 97-8 
R 98.2 
L 98.2 
1050 
12.50 " 
R 98.8 R 97.8 
L98.6 L98 
R 98 8 
L 98.6 
R 98 4 
L 98 2 
R 98.8 
L 98.8 
R 98.6 
L 98.4 
R 99.6 
L 99.2 
Widest axillary variation = 2.4 
Average axillary variation = .22 
Case VI.-W. P.; male; age 39; married; three 
children ; laborer ; habits very intemperate; common 
school education ; born in Ireland. Duration of insanity 
about three years. Patient is in the last stages of gen- 
eral paresis. Speech thick and articulation is almost 
impossible ; destructive and filthy in habits ; very tremu- 
lous and paretic; very demented; mind almost a com- 8 
PAR AL YSIS OF THE INSANE. 
plete blank. Staggers in walking and is now in bed 
much of the time. Pupils unequal 1 > r. Knee-jerk some- 
what exaggerated on both sides, but more so on the left 
than on the right. 
Hours. 
ist day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day 
1-45 
P.M. 
98.2 
98.4 
99-4 
99 
98.8 
98.6 
98.8 
3-45 
(< 
98.6 
98.6 
98.6 
98 8 
98.6 
98.6 
99 
5 45 
i i 
98.6 
98.4 
98.2 
98.4 
99 
98.6 
99 
7-45 
(i 
98.4 
97-8 
99 
98.8 
98 
98.6 
99 
9-45 
i L 
98.8 
98 4 
99 
98.2 
98. 2 
98.4 
98.8 
U-45 
98 
98.2 
98.4 
98 
98 
98.2 
98 6 
i-45 
A.M. 
98 
98 
98 
98.2 
98 
98.2 
98.4 
3-45 
97 6 
98 
98 
98.4 
98 
98 
98.2 
5-45 
97-6 
98.6 
98.4 
97 8 
98.2 
97-8 
98.4 
7-45 
u 
98.2 
98.2 
98.4 
97-4 
98.2 
98.4 
98.6 
9-45 
< c 
97-6 
98.8 
99 
97.6 
98.2 
98.8 
98.6 
ii-45 
I I 
98.6 
99-2 
98.6 
98.6 
98-4 
98.8 
98.8 
Widest daily 
variation 
1.2 
i-4 
1.2 
1.6 
I. 
i. 
.8 
Case VI.-W. P. The following observations were 
taken about six weeks after the preceding ones, no very 
special change occurring in the patient's condition dur- 
ing this time. 
TABLE CONTRASTING BOTH AXILLARY TEMPERATURES. 
CASE VI. 
Hours. i st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
2.20 P.M. 
R IOI.I 
R IOO 4 
R IOO 4 
R 99.8 
R 99-3 
R 99 
4.20 " 
L 101 
R 100.8 
L 100.6 
L IOO 
L IOO 
L 99.2 
L 99 
L 98.9 
6.20 " 
R 100.4 
R 99.6 
R 100.6 
R 99.6 
R 99.4 
R 98.9 
8 20 •' 
L 100 2 
R 100.4 
L 100.2 
L 99-4 
L 100 4 
L 99 2 
L 98.6 
L 98 8 
10.20 " 
12.20 A.M. 
R 100 
L 98.8 
R 98.8 
L 99-4 
R 99.4 
L 99 2 
R 99 
L 99.1 
R 98.8 
L 99-5 
R 99.4 
L 99-1 
2.20 " 
4.20 " 
R 99.8 
L 99-9 
R 99.6 
L 99.2 
R 98 6 
L 98.2 
R 98.8 
L 98-9 
R 99.4 
L 99.2 
R 98 9 
L 98.8 
6.20 " 
8.20 " 
R 99.6 
L 99 4 
R 99.8 
L 99-4 
R 98.6 
L 98.2 
R 99 
L 99 
R 99.4 
L 99-3 
R 99 
L 98.9 
10.20 " R 100.8 
R 100 6 
R 100.2 
R 99.2 
R 99 
R 98.8 
L 99-4 
12.20 P.M. R 100.4 
L 100 3 
L 98.8 
L 100 
L 99.2 
L 98 9 
L 98.8 
Widest axillary variation = 1.8 
Average axillary variation = .34 FREDERICK PETERSON. 
9 
Case VII.-J. R.; male; age 34; married; two chil- 
dren ; horse jockey ; very intemperate habits. Born in 
New York. Duration of insanity about three years. 
Patient is now very demented. Speech thick and hesi- 
tating. Tongue and lips tremulous. Has delusions of 
wealth and exaltation. Always happy. Mind is almost 
a complete blank. Staggers when walking. Is gen- 
erally paretic. Pupils unequal, r > 1. No patella reflex 
on the right side, and much diminished on the left. 
Hours. 
ist. day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
2 P.M. 
99-4 
98 
98.6 
98.8 
98.6 
99 
99-2 
4 " 
99 
98.6 
98 
98.6 
98.4 
98.8 
98.8 
6 " 
99-2 
100 6 
98.4 
98.4 
too 
100 
99-6 
8 
99 
98.6 
99 
98.4 
98.8 
99-2 
99 
IO " 
98.6 
98.4 
99 
98.4 
98.8 
99 2 
99 
12 " 
99 
98.4 
98.8 
98.2 
98.6 
99 
99 
2 A.M. 
98.8 
98.2 
99 
98.2 
98.2 
99 
98.8 
4 " 
98.2 
98.4 
98.4 
98 
98 
98.8 
98.8 
6 " 
97-8 
98.4 
97-8 
98.4 
98 
98.2 
98.2 
8 " 
97-8 
98.8 
99 
98.4 
98.8 
98.6 
98.8 
IO " 
99 
98.4 
99 
99 
98.6 
98.8 
98.8 
12 " 
98.4 
98.4 
99 
98.8 
98.6 
99 
98.8 
Widest daily 
variation. 
1.6 
2.6 
1.2 
1-4 
2. 
1.8 
1-4 
Case VIII.-C. S.; age 50 ; married ; two children ; 
reads and writes. Intemperate habits. Carpenter. Born 
in England. Duration of insanity nearly four years. 
Is very demented, but still has delusions of wealth and 
importance. Dirty in habits. Speech slow and difficult. 
Very paretic and tremulous. Gait unsteady and totter- 
ing. Has mitral insufficiency murmur. Has had several 
paretic attacks. 
Hours. 
ist day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
2 P.M. 
98-4 
98.4 
98.4 
99 2 
9 88 
98.6 
99 
4 
98.2 
99 
97-6 
98.8 
98.2 
98.8 
99-2 
6 
98 4 
99-8 
98 
98.8 
98.4 
98.2 
99-8 
8 
98.2 
97-8 
98.6 
97.8 
97-8 
98.4 
98.4 
IO " 
98.2 
98.2 
9§ 4 
97-8 
97.8 
98 2 
98.2 
12 " 
98.2 
98 
98 2 
97 8 
97-8 
98.2 
98.2 
2 A.M. 
98 
98.2 
98 
97-8 
98 
98.2 
98.2 
4 
98 2 
98 
98 
97-8 
97-8 
98 
98.4 
6 
97-6 
97-4 
97 & 
97-8 
98.2 
98 
98.4 
8 
97-6 
98 
98.6 
98.8 
98.4 
98.8 
98.6 
IO " 
98.6 
97-6 
98.8 
97-8 
98.2 
99 
98.8 
12 " 
98.4 
98 
98.8 
98.2 
98.4 
99 
99 
Widest daily 
variation. 
1. 
2.4 
1.2 
1-4 
I. 
1. 
1.6 
Case VIII.-C. S. The following observations were 
taken about six weeks after the preceding ones, no very 
special change occurring in the patient's condition dur- 
ing this time. 10 
PARAL YSIS OF THE INSANE. 
TABLE CONTRASTING BOTH• AXILLARY TEMPERATURES. 
CASE VIII. 
Hours. 
i st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
1.20 
P.M. 
R 98.6 
L 98.4 
3-20 
4 4 
R 98.6 
R 99.2 
R 98.8 
R 98.4 
R 99.2 
R 98.8 
L 98.4 
L 99.2 
L 98.6 
L 99 
L 98 9 
1. 98.6 
5-20 
4 4 
R 98.6 
L 98.6 
7.20 
44 
R 99 
R 99.4 
R 99 
R 98.4 
R 99 
R 98.8 
I. 98.6 
L 99 
I. 98.6 
I.98.3 
L 98.6 
1.98.7 
9.20 
4 4 
R 99 
L 99.2 
11.20 
4 4 
R 99.2 
R 98 
R 97.8 
R 98 5 
R 99.2 
L 99 
L 97.6 
L 97-5 
I. 98.6 
L 99 
1.20 
A.M. 
R 99 
L 99 
3-20 
44 
R 99.2 
R 97.9 
R 98 
R 98 
R 98.7 
L 99 4 
L 97.8 
L 97.8 
L 98.1 
L 98.6 
5-20 
R 97.4 
L 97-4 
7.20 
4 4 
R 97.8 
R 98.2 
R 98.3 
R 98 
R 98.9 
L 97.6 
L 98.2 
I. 98.2 
I. 98 
I. 98.6 
9.20 
R 98.2 
L 98 
11.20 
4 4 
R 98.2 
R 98.6 
R 98.4 
R 98.4 
R 98.2 
R 99 
L 98.2 
L 98.6 
L 98 4 
L 98.4 
L 98.2 
L 98.8 
Widest axillary variation = .6. 
Average axillary variation - .16. 
Case IX.-A. M.; age 62 ; male ; married; father of 
ten children ; painter; common school education. Born 
in Germany. Duration of insanity about three years. 
Is in the last stages of general paresis. Is in bed. Very 
demented. Has no control over sphincters of bladder 
and rectum. No knee-jerk on right side ; on the left it is 
slightly exaggerated but in a few minutes disappears, 
the centre becoming exhausted, but after a few minutes 
rest is again present for a short time. 
Hours. 
1st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
2.15 
P.M. 
97-4 
98.4 
99 
98 
98.4 
98.6 
98.4 
4.15 
44 
98 
97-8 
98.4 
97-4 
99-2 
97-8 
98.4 
t> 15 
4 4 
98 
97-8 
98.8 
98.4 
98.6 
99 
97-8 
8.15 
4 4 
98.2 
98 
98.8 
98.4 
98.6 
99-2 
98.8 
IO.15 
4 4 
97-6 
98 
98.6 
98.2 
98.2 
99 
98 8 
12.15 
4 4 
98.6 
97-8 
98 
98.2 
98.2 
99 
98.4 
2.15 
A.M. 
98.2 
97-8 
98.2 
98 
98.2 
98.8 
98.4 
4.15 
< 
98.2 
97-6 
98 
98 
98 
98 
98 4 
6.15 
4 4 
96.6 
97 8 
97-8 
97-4 
97-8 
98 
98.4 
8.15 
4 4 
98 
98.6 
98 
98 
97-8 
98.4 
98.6 
IO.15 
< < 
98 
97-8 
98.2 
98 
98 
98.4 
98.4 
12.15 
97-8 
98 
98.2 
98.6 
97-8 
98.6 
98.4 
Widest daily 
variation. 
1.2 
1. 
1.2 
1.2 
1-4 
i-4 
1. FREDERICK PETERSON. 
11 
Case X. - H.; age 41 ; male ; single ; salesman ; 
academic education ; good habits. Born in New York. 
Duration of insanity three and one half years. Pupils 
irregular and unequal. Knee-jerk subnormal. Is in 
bed. Very tremulous and paretic. Has had delusions 
of the greatest wealth and exaltation. Is extremely de- 
mented and mind is now a complete blank. Has no con- 
trol over his sphincters. Has trophic changes in skin 
over trochanters and heels ; has also a bed sore over the 
sacrum. Is in the last stages of general paresis. 
Hours. 
1st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
2.15 P.M 
99-6 
98.6 
99-4 
98.4 
99 4 
IOI.2 
IOO 2 
4-15 
99-2 
98.6 
99 
98.4 
IOO.4 
101.8 
100 8 
6.15 
99 
99- 2 
99-2 
99-2 
IOO.2 
101.4 
100.2 
8.15 " 
98.8 
98.8 
99-4 
99 
IOO 
100.8 
99.8 
10.15 " 
98.6 
98.4 
98.4 
99 
99-4 
100.2 
99-8 
12.15 " 
98.2 
98.4 
98.6 
98.6 
98.4 
99- 6 
99-6 
2.15 A.M. 
98 
98.6 
98 
98.4 
98.6 
99.2 
99-6 
4-15 
97.6 
98.2 
98.8 
98.2 
98.4 
99-8 
99-4 
6.J5 
98 
97-6 
97-8 
97-8 
98.4 
98.4 
99-4 
8.15 " 
98.2 
99 
98.2 
98.2 
99-4 
99-8 
98.4 
10.15 " 
98.6 
98.4 
98.6 
99-2 
100.6 
99-4 
98.8 
12.15 " 
99 
100.2 
98.6 
98.2 
101 
100.2 
99-4 
Widest daily 
variation. 
2. 
2.6 
1.6 
1-4 
2.2' 
3-4 
2-4 
About three weeks after these observations the patient died at his 
home. 
Case XL-E. M. C. ; male; age 44; married ; father 
of six children ; common school education; carpenter; 
intemperate habits; has had syphilis. Born in New 
York. Duration of insanity about twenty months. Is 
tremulous, paretic. Gait somewhat feeble. Has halluci- 
nations of hearing. Is demented. Pupils unequal, 1 < r. 
Both knee-jerks exaggerated, but the left more so than 
the right. 
Hours. 
2.30 P.M. 
4.30 " 
1st day. 2d day. 
3d day. 
98.2 
98 
4th day. 
97-8 
98 
5th day. 
98 
99-6 
6th day. 7th day. 
08.4 
98.2 
98.2 
98.6 
98 
98.6 
98.8 
6 30 
98.4 
98 
98.4 
98 
99 
99 
98.4 
8-3° " 
98.6 
98.8 
98.4 
99 
99-4 
99 
10.30 " 
98.8 
98.4 
98.8 
98.4 
98.8 
99-2 
98.6 
12.30 " 
99 
98.4 
98.4 
98 
98.2 
98.8 
98.8 
2.30 A.M. 
98.8 
98.4 
98.2 
98.2 
98.2 
98.6 
98.6 
4-3° " 
98.4 
98 
98.2 
98 
98.2 
98.4 
98.4 
6 30 " 
97-6 
98.8 
97-8 
97-8 
98.2 
97-8 
98.4 
8.30 " 
98 
99 
97-8 
98.4 
98.4 
98.4 
98.4 
10.30 " 
97-4 
98.2 
97.6 
98.4 
98.8 
98.2 
98.4 
12.30 " 
98-4 
97 8 
98 
98.4 
98.4 
98.4 
98.4 
■ 11 
Widest daily 
variation. 
1.9 
1.2 
1.2 
.6 
1.6 
1.8 
.6 12 
PAR AL YSIS OF. THE INSANE. 
Case XII.-C. J. H.; male; age 40: married; six 
children ; hack driver ; common school education ; habits 
always very intemperate. Has probably been given to 
sexual excess. Born in New York. Father died insane. 
Duration of insanity about one year. Is now very de- 
mented. Pupils dilated, but irregular and unequal, 
1 > r. Knee-jerks subnormal. Has lost control of his 
sphincters. Is very tremulous and paretic. Gait stag- 
gering. 
Hours. 
1 st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
2 30 P.M. 
98.6 
99-8 
98.4 
98.2 
98.8 
98 4 
98.8 
4-3° 
98.6 
98-4 
98.4 
98.4 
98.8 
98.6 
99 
6.30 
98.8 
98.4 
98.8 
98 8 
98.4 
98.8 
98.6 
8 30 
98.2 
97-6 
98.2 
98.4 
98.2 
98.6 
98.6 
10.30 " 
98 
98 
98 
98.2 
98.2 
98.6 
98.6 
12.30 " 
98.2 
97-6 
98 
98.4 
98 
98.4 
98.4 
2 30 A. M. 
98 
97-8 
97-6 
98 
98 
98.4 
98.2 
4 30 " 
98.4 
97-8 
97.6 
97-6 
98 
98.2 
98.2 
6.30 
97-2 
97-6 
98.6 
98.6 
98 
98 
99-2 
8.30 " 
97-4 
97-8 
98.4 
98.6 
98.6 
98.6 
99.2 
10.30 " 
98.8 
97-8 
98.4 
99 
98.6 
98.6 
99-4 
12.30 " 
98.2 
98.6 
98.6 
99-2 
98.4 
99-2 
99-4 
Widest daily 
variation. 
1.6 
2 2 
1.2 
1.6 
.8 
1.2 
1.2 
Case XIII.-C. B. L.; male; age 44 ; married ; boat- 
man ; no education ; intemperate habits. Born in New 
York. Duration of insanity three years. Is now very 
demented, but happy. Is tremulous and paretic. Gait 
staggering. Pupils unequal, 1 > r. Knee-jerks slightly 
exaggerated, left more so than the right. 
Hours. 
1 st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
2.45 P.M. 
98 
97 4 
97.6 
98 
98.4 
98.2 
98.4 
4 45 " 
98.2 
97-4 
97-4 
98 4 
97-8 
98 
98.2 
6-45 
98.2 
97-2 
97-4 
97-6 
97-8 
98.2 
99 
8-45 " 
98 
97-4 
98 
97-8 
98 
98.2 
98.8 
10.45 " 
9s 
97-8 
97-8 
97-8 
98 
98 
98.4 
12.45 " 
97-8 
97-8 
98 
97-8 
98 
98.8 
98.2 
2.45 A.M. 
97-6 
97-8 
97-6 
97-4 
97-8 
98 
98.4 
4-45 " 
97-6 
97-6 
97-4 
97-4 
97-6 
98 
98.4 
6-45 
97-4 
97-4 
97-2 
97-8 
97-8 
97-8 
98.4 
8-45 " 
97-6 
97-4 
97-8 
98.4 
97-8 
98 4 
98.4 
10 45 " 
97-8 
97 2 
97-4 
98 
98 
98.2 
98.4 
12.45 " 
97 4 
97-4 
97-6 
98.4 
98 
98.4 
98-4 
Widest daily 
variation. 
.8 
.6 
.8 
1. 
.8 
1. 
.8 
Case XIV.-J. H.; male; age 48 ; married; father of 
six children; clerk ; temperate habits, but has had 
syphilis. Common school education. Born in Ireland. FREDERICK PE PERSON. 
13 
Duration of insanity about eighteen months. Is now 
quiet, but has delusions of wealth and grandeur ; is be- 
coming demented. Mentalization slow. Is dull, con- 
fused, but at times very emotional. Pupils are irregular, 
sluggish and unequal, r > 1. Speech is indistinct, 
hesitating and stuttering. Gait is unsteady. Has gen- 
eral muscular tremors. Both knee-jerks very much 
exaggerated. 
Hours. 
1st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
1.30 P.M. 
97-8 
97-8 
97.6 
98 
98 4 
99 
98.8 
330 " 
98.2 
97.6 
98.6 
98.4 
99 
98.4 
99 
530 " 
97-8 
97-8 
98.4 
98.6 
98 
99-4 
99 
7 3° " 
97-8 
98 
98 8 
98.4 
98 6 
99 
99-6 
9 30 " 
97-8 
98 
98 
98 
97 8 
99 
98.8 
11.30 " 
97-8 
97-6 
98 
98 
98 
99 
98.8 
1.30 A.M. 
97.6 
97-8 
98 
98.2 
98 
99-6 
99 
3-30 " 
97-4 
98 
98.4 
98 
97-8 
99-4 
99 
5-30 " 
97 8 
97-6 
97-8 
97 8 
98 
99-2 
99 
7-30 " 
97-8 
97.6 
97-6 
97-8 
97-8 
97-8 
97-4 
9-3° " 
97.6 
97-8 
98 2 
98.2 
98.4 
98 
98 
11.30 " 
97 8 
97-8 
97-8 
97-8 
98.4 
98 
97.6 
Widest daily 
variation. 
.8 
• 4 
1.2 
.8 
1.2 
1.8 
2.2 
Case XV.-T. P. ; male ; age 37 ; single ; carpenter; 
habits temperate. Common school education. Born in 
Massachusetts. Is in the third stage of general paresis. 
Has delusions of the greatest wealth and exaltation, but 
is demented. Dirty in habits. Is very tremulous. 
Gait unsteady. Articulation slow and difficult. At 
times emotional. Pupils unequal, 1 > r. Knee-jerks 
and ankle clonus exaggerated on both sides. 
Hours. 
ist day. 
2d dav. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
1.45 P.M. 
98.2 
98.6 
99 
98.8 
IOO.2 
98.6 
99 
3 45 
IOO 
97.8 
99-4 
99 
100 8 
99 
99- 
5-45 " 
99-8 
98.4 
IOO 
99-4 
101 
IOO 
99-4 
7-45 " 
99 
98.8 
99 
100.2 
99 
99-2 
99 8 
9-45 ' ' 
99 
97-8 
98 
IOO 2 
98 
98 
99 
H-45 " 
98 
98.8 
97-8 
99-2 
99 4 
98.4 
99-2 
1.45 A.M. 
98.4 
99 
98 
98 
99-2 
99-4 
99-4 
3-45 " 
98 
98 
97.6 
98.6 
99 
99 2 
98.4 
5 45 " 
98 
98 
97-6 
98.8 
99 
99-2 
98 
7-45 " 
97-8 
IOO 
98.4 
98.6 
99-2 
98.6 
97-8 
9 45 
98.8 
98.4 
98 8 
98.4 
99-2 
99 
98.4 
1145 " 
98 
98.6 
99 
99 
99 
98.6 
98 
Widest daily 
variation. 
2.2 
2.2 
2.4 
2.2 
3- 
1.6 
2. 
Case XV.-T. P. The following observations were 
taken about six weeks after the preceding ones, no very 
special change occurring in the patient's condition dur- 
ing this time. 14 
PARAL YSIS OF THE INSANE. 
TABLE CONTRASTING BOTH AXILLARY TEMPERATURES. 
CASE XV. 
Hours. 
ist day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
2.40 
P.M. 
R 99.2 
R 99 
R 99.8 
R 98.4 
R 99.4 
R 99 
I, 99.4 
I. 98.6 
L 99.6 
L 98.4 
L 99-3 
L 98.8 
4-4° 
6.40 
u 
R 99.4 
I. 99.4 
R 99 
R 99.7 
R 99 
R 99.4 
R 98.2 
R 98.4 
L 99 2 
I. 99.4 
L 99 2 
I. 99.2 
L 98.2 
I. 98.8 
8.40 
R 98.4 
I. 99.2 
10.40 
<< 
R 99 
R 100.4 
R 99.6 
R 98.9 
R 99-5 
L 99 
R 100.1 
L 99.8 
L 98.6 
L 99.6 
12.40 
C ( 
R 98 4 
R 99-5 
2.40 
A.M. 
R 98.4 
R 99.8 
R 99 
R 98.9 
R 99 
I. 98.4 
L 99.7 
L 98.7 
L 98.7 
L 98.9 
4-40 
R 99 
L 99.2 
6.40 
< < 
R 99 
R 99.8 
R 99 
R 98.6 
R 98.8 
L 99 
L 99.6 
L 98.8 
LJ98.5 
L 98.6 
8.40 
R 99.2 
I. 99.2 
10.40 
' ' R 98 4 
R 99.8 
R 99.8 
R 99.2 
R 99.2 
R 98.8 
L 98.6 
L 98.4 
L 99.6 
L 99 
L 99 
I. 98.6 
12.40 
" R 99.2 
I. 99.4 
Widest axillary variation = 1.9. 
Average axillary variation = .23. 
Case XVI.-M. L. P.; male ; aged forty-one ; married; 
two children ; farm laborer ; common school education. 
Intemperate habits. Born in New York. Duration of 
insanity about twenty months. Has delusions of the 
greatest wealth and importance. Has auditory halluci- 
nations. Is very emotional. Stammers and hesitates in 
speech. Gait very unsteady. Is quite demented. Of 
late has gained considerable in flesh. Pupils are unequal, 
r > 1. Knee-jerk diminished on both sides, but less on 
the left than on the right. 
Hours. 
i st dav. 
2d dav. 
3d day. 
4th dav. 
5th dav. 
6th dav. 
7th day. 
2 P.M. 
98. 8 
98 
98 4 
98.4 
98.8 
99-6 
98.8 
4 " 
98 
98.8 
99 
97-8 
98 
98.4 
98 
6 " 
98 
98 
98.2 
99 
98 
98.4 
98 
8 
97-6 
98 
97-8 
99 
97-8 
98 
97-8 
IO " 
97-6 
97-8 
97-6 
98.4 
97-6 
98.2 
97-8 
12 " 
97-6 
97-6 
97-6 
97-8 
97-6 
98 
97-8 
2 A.M. 
98.2 
97-6 
98 
97-8 
97 & 
97-6 
97-4 
4 " 
97-8 
97 
97-6 
97-8 
97 8 
97-6 
97-4 
6 
97-6 
98 
97-6 
98 
97.6 
97-8 
97-6 
8 " 
98 
98 
97 8 
98 
98.4 
98.4 
98.4 
IO " 
96 
98 
98.2 
98.2 
98.2 
99.2 
99 
12 " 
98.8 
99 
98 
98 2 
99 
98.4 
98.4 
Widest daily 
variation. 
1 4 
1.4 
1-4 
1.2 
i 4 
2. 
1 6 FREDERICK PETERSON. 
15 
Case XVII.-J. E. C.; male; age 43; married ; two 
children; book-keeper; good habits. Born in New 
York. Father was insane. Duration of insanity about 
four years, there being a partial remission of a few 
months after the first two years of insanity. The patient 
is now very much elated and has delusions of the great- 
est wealth and importance. Pupils are dilated, irregular 
and unequal, r > 1. Tongue and lips tremulous. Artic- 
ulation much impaired. Gait staggering and unsteady. 
Is very emotional. Knee-jerk absent on both sides. 
Hours. 
I.45 P.M. 
1 st day. 
IOO.6 
2d day. 
98 
3d day. 
98 4 
4th day. 5th day, 6th day. 7th day 
99 
98-4 
98.8 
98.4 
3-45 " 
IOI.2 
98.8 
98.4 
99 
98.4 
97.6 
99-4 
5-45 " 
IOO.4 
100 
98.8 
99-2 
99 
99-2 
101.6 
7-45 " 
IOI 
99-8 
98.4 
99 
98 
98.4 
98 4 
9-45 " 
IOI.2 
99 
97-8 
99-2 
99 
98.6 
99 
11-45 " 
100.6 
98 
97-8 
98.8 
97-8 
98.2 
9s 
1.45 A.M. 
99 
97-8 
97-8 
97-8 
97-8 
97-8 
98 
3-45 " 
99 
97-4 
97-8 
98 
97-8 
97-8 
98 
5-45 " 
98.2 
97-8 
97-8 
98.4 
98 
98.4 
98 
7-45 " 
98 
98.4 
98.8 
98.4 
98.8 
98.4 
98.8 
9-45 " 
98.4 
98.6 
99 
98.4 
98.4 
97.6 
98.4 
11.45 " 
98 4 
98.4 
98 
98.8 
98.2 
98.8 
97-8 
Widest daily 
variation. 
3-2 
2.6 
1-4 
i-4 
1.4 
1.6 
3-8 
Case XVII.- J. E. C. The following observations 
were taken about six weeks after the preceding ones, no 
very special change occurring in the patient's condition 
during this time. 
TABLE CONTRASTING BOTH AXILLARY TEMPERATURES. 
CASE XVII. 
Hours. 
1st day. 2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
I P.M. 
R 99 
L 99.2 
3 
R 98 
R 98.8 
R 99.8 
R 99.4 
R g8.6 
R 98.2 
L 98.5 
L 98.8 
L99.8 
L 99 
L 98.3 
L 98 
5 
R 98.2 
L 98.4 
7 
R 98.4 
R 98.4 
R 99.2 
R 99.6 
R 98.2 
R 98.3 
L98.5 
L 98.8 
L 98.4 
L 99.6 
L 98.9 
L 98.1 
9 
R 98.4 
L 98.4 
ii ' 
R 97.8 
R loo 
R 98.9 
R 98.9 
R 98 
L 98.2 
L 98.7 
I. 98 6 
I, 98.8 
L 98 1 
I A.M. 
R 98.6 
L 98.2 
3 " 
R 99 
R 98.9 
R g 8 
R 98.6 
R 97.8 
L 99 
L 99 
L98 
L 98.4 
L 97-9 
5 
R 97.6 
I- 97-5 16 
PAR AL YSIS OP THE INSANE. 
7 
R 98 
L 98 
R 98.8 
L 98.8 
R 99.4 
I. 99 2 
R 98.2 
L 98 
R 98 
L 98 
9 
R 98.2 
L 98 
ii 
R 98 4 
R 98.4 
R 98.8 
R 99.6 
R 98.6 
R 98.2 
L 98.4 
L 98.2 
L 98.8 
L 99.4 
L 98.4 
L 98 
Widest axillary variation = 1.3 
Average axillary variation = . 21 
Case XVIII.-W. F. V.; male; age 40; married; 
father of two children ; salesman ; common school edu- 
cation ; habits temperate. Born in England. Duration 
of insanity about eighteen months. The patient is now 
having a partial remission and has become quite fleshy. 
At one time was quite noisy, loquacious, exalted, had 
delusions of the greatest wealth and importance. For 
the past six months has been quiet, but somewhat de- 
mented. Is happy. Tongue, lips and fingers tremu- 
lous. Articulation impaired. Pupils unequal, irregular 
and contracted, but 1 > r. Knee-jerk exaggerated. Has 
a haematoma auris. 
Hours. 
1st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
I.30 P.M. 
98 
98 
98 
98.2 
98.8 
98 
98.8 
3-3° " 
98.4 
97-4 
97-8 
98.8 
99-4 
98 
98.8 
5.30 " 
98 
97.6 
98.2 
98.6 
98.4 
99 
99 
7-30 " 
97.6 
98 
98.2 
98.6 
98 
98 
98.2 
9-30 " 
97-8 
97-8 
97-8 
98 
98-4 
98. 2 
98.4 
11.30 " 
97.8 
97-8 
98 
97 6 
98 
98. 2 
98.4 
1.30 A.M. 
97-5 
97-8 
98 
97.6 
98.4 
98.8 
98 
3-30 " 
97-5 
97-8 
97-8 
98 
98 
98 
98 
5-3° " 
98-4 
97-8 
97-4 
97.6 
97-8 
97-8 
98 
7 30 " 
97 5 
97-8 
97-4 
97-8 
97-8 
97-8 
97 2 
9-30 " 
97 6 
97-8 
97.6 
98 
984 
97 (> 
97 
1130 " 
97-4 
97-4 
97-4 
97 8 
98 
97-4 
Widest daily 
variation. 
1. 
.6 
.8 
i-4 
1.6 
1-4 
1.8 
Case XIX.-A. V.; male; age 39; married; two 
ehildren ; laborer ; common school education ; temperate 
habits. Born in Canada. Duration of insanity two 
years. Is now demented, but happy ; is very forgetful, 
and frequently does not remember his own name. 
Hesitates in speech ; staggers in walking. Both pupils 
are dilated, irregular and unequal, r > 1. Knee-jerk 
greatly diminished on both sides; almost nil on the left. FREDERICK PETERSON. 
17 
Hours. 
1st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
I.30 P.M. 
99 2 
98 
98 
98 4 
97-8 
97 8 
98.2 
3-30 " 
98.2 
97-8 
97 4 
98 8 
98 
97-6 
98.4 
5-30 " 
98.6 
98-4 
98.6 
97-8 
98.4 
99-8 
98.4 
7-30 " 
98.8 
97.6 
97 6 
97-4 
98 
98 4 
97-4 
9-3° " 
98.6 
97-8 
97-8 
97 4 
97-4 
97 & 
97-8 
11-30 " 
97.8 
97-8 
97-4 
98 
97-4 
97.6 
97-8 
1.30 AM. 
97.6 
97-5 
97.8 
97-4 
97-4 
97-4 
97-8 
3 30 " 
97-8 
97-4 
97-4 
97-2 
97 8 
97 4 
97 4 
5-30 " 
97 3 
97 8 
97-4 
97-6 
97-8 
97-8 
97-4 
7-3° " 
97-8 
98.2 
98 
98 
98 
9s 4 
98.4 
9-3° " 
98 
97.6 
97 8 
9s 
9s 4 
9s 
98 
11.30 " 
97-8 
98.2 
98 4 
97-8 
98.4 
98.2 
97-8 
Widest daily 
variation. 
1.6 
1. 
1.2 
1.6 
1. 
2.4 
1. 
Case XX.-E. P. C.; male; age 35; married; three 
children; tinsmith ; intemperate habits. Born in New 
York. Duration of insanity fifteen months. Has been 
noisy, incoherent, homicidal; has had, and still has, de- 
lusions of the greatest wealth and exaltation, but is now 
becoming quieter and more demented. Gait unsteady 
and staggering. Articulation slow and difficult. Speech 
thick and hesitating. Tongue and lips tremulous. 
Pupils are somewhat contracted, irregular and unequal, 
r > 1. Knee-jerk slightly diminished on both sides. 
Hours. 
i st dav. 
2d day. 
3d dav. 
4th dav. 
5th day. 
6th dav. 
7th dav. 
2 P.M. 
98 
97-4 
97.6 
98.6 
98 
98.6 
98 6 
4 " 
98.4 
97 6 
98-4 
98.4 
98 
9S.8 
97 8 
6 
99-2 
97-4 
98.8 
IOO 
98.6 
99 
98. S 
8 
98 
98.2 
98.6 
99 
98-4 
98.8 
98.6 
IO " 
97.8 
98 
98.6 
98 
98 
98 
98.4 
12 " 
97-8 
98 4 
98.6 
984 
98 4 
98 6 
99 
2 A.M. 
97 8 
98 4 
98 
9s 4 
99 
99 
99 
4 
97-8 
98 2 
97-8 
' 98 
98 
97-9 
98.4 
6 
97-8 
97-4 
97.6 
97-8 
97-8 
98 
97-8 
8 
97-8 
97-4 
97.6 
97.6 
97 4 
97.6 
97 8 
IO " 
97-8 
97- 
97 8 
97-4 
97 8 
9s 
98 
12 " 
97-6 
97 8 
97 8 
97.6 
97-8 
97 6 
97-6 
Widest daily 
variation. 
1.6 
I. 
1.2 
2.6 
1.6 
I 4 
I 4 
Case XX.-E. P. C. The following observations were 
taken about six weeks after the preceding ones, no 
very special change occurring in the patient's condition 
during this time. 
TABLE CONTRASTING BOTH AXILLARY TEMPERATURES. 
CASE XX. 
Hours. 
1st day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th day. 
■th day. 
I.30 P.M. 
R 98 6 
I- 98-5 
3 30 " 
R 98 2 
R 98.2 
R 98.8 
R 98.2 
R 98.4 
R 98.6 
I, 98 
1. 98 
L 98 6 
1.98 
1 ■ 9s 3 
1- 98.3 18 
PAR AL YSIS OF THE INSANE. 
5-3° " 
R 98.4 
L 98.4 
7-30 " 
R 99.2 
R 98.8 
R 98.4 
R 98.2 
R 99.2 R 98.5 
L 99.8 
L 98.6 
L 98.8 
L 98 
L 98 8 L 98.2 
9*3° " 
R 99 
L 98.8 
n.3° " 
R 97.8 
R 98.8 
R 98.4 
R 99 
R 98.6 
L 9.7.6 
L 99 
L 98.4 
L 99 
L98.5 
1.30 A.M. 
R 98.6 
1. 98 4 
3 30 " 
R98.4 
R 98 
R g8 1 
R 98 8 
R 98 4 
L 98 4 
I. 97 8 
L 98.2 
L 98 6 
L 98.4 
5-30 " 
R 98 2 
1-98 4 
7-30 " 
R 98 4 
R 98 2 
R 98.4 
R 98.2 
R 98 4 
L 98 4 
I.98 
L 98 4 
L 98 
I- 983 
9 30 " 
R 98.6 
L 98 4 
11 30 " 
R 98,4 
R 98 6 
R 98 6 
R 98 6 
R 98.4 
R 98 4 
L 98.2 
I, 98 7 
L 98.3 
L 98.6 
L 98 3 
L 98 3 
Widest axillary variation = .6 
Average axillary variation = .16 
Case XXI.-E. S.; male ; age 40; single ; collector; 
common school education. Good habits. Born in New 
York. Duration of insanity about four years and a half. 
Is now much demented, but has hallucinations of sight 
and hearing. Filthy and destructive in habits. Is 
tremulous and paretic, but is up and about. Pupils 
irregular and unequal, 1 > r. Knee-jerk diminished on 
both sides, but is slightly stronger on the left than on 
the right. 
Hours. 
ist day. 
ad day. 
3d day. 
4th day. 
5th day. 
6th day. 
7th day. 
I P.M. 
99-4 
99-6 
99-8 
99.6 
98 4 
99 
99 
3 '* 
99-8 
99 2 
IOO 
99 
98.6 
99 
99-2 
5 " 
99-8 
99 2 
IOO 2 
99-2 
99 
99 8 
99-2 
7 *" 
99 4 
99 
99 8 
99 
99 
99 8 
99 
9 
99 2 
99 4 
99 
9s-4 
98.4 
98.2 
99 
II 
99-2 
99-2 
98.8 
98.2 
98.4 
98 
98 6 
I A M. 
99 
99 
99 
98 2 
98 
97.6 
98.2 
3 " 
99-2 
98.8 
98 
97-8 
97.6 
97-4 
98.2 
5 " 
99 
99 
98. 2 
97.6 
97 2 
99 4 
98 
7 
99-4 
98.8 
99 2 
98 
98.8 
98.8 
98 2 
9 
99-6 
99 
99-4 
98 4 
98 8 
98.6 
98.6 
ii " 
*99-8 
99 2 
99 
98.2 
98.8 
99 
98.8 
Widest daily 
variation. 
.8 
.8 
2 2 
2. 
1.8 
2-4 
1 2 
Case XXII.-J. C. B. ; male; age 52; married; 
father of five children; confectioner; common school 
education; intemperate habits. Born in England. 
Duration of insanity fifteen months. Is now demented 
but happy. Pupils contracted and do not respond to 
light. Tongue, lips and fingers tremulous, (fait un- FREDERICK PETERSON. 
19 
steady. Speech thick and hesitating. Articulation dif- 
ficult. Patella reflex absent on both sides. 
Hours. 
ist day. 
2d day. 
3d day. 
4th day. 
5th d<y- 
6th day. 
7th day. 
2 P.M. 
98 
98 
98.2 
98-4 
99 6 
98 
97-8 
4 
98 2 
98 
97-4 
99 
98,6 
97-4 
97-8 
6 
98.4 
99 
97 8 
98. 2 
98.4 
98.6 
98 
8 
97-4 
98.4 
98.4 
98. 2 
99 
98 4 
99-2 
IO " 
98.4 
98.6 
97-8 
98.8 
98.4 
98.4 
98 4 
12 " 
98 4 
98 
9s 
99-4 
98 
98.4 
98 4 
2 A M. 
97-8 
98.6 
98 
99 
99 
98 8 
98 
4 
98 
99.2 
98.4 
98 8 
98 4 
98 8 
98 4 
6 
98 
98 
99 
97.6 
984 
98 
98 
S 
97-8 
98.2 
98 
98 6 
98.2 
98.4 
98 
IO " 
97 8 
97-8 
97.6 
97-8 
97.6 
98.4 
98.2 
12 " 
97-8 
97 8 
98.2 
98 
98 4 
98 6 
98 
Widest daily 
variation. 
1 
I 4 
1 6 
1 8 
2. 
I 4 
I 4 
Case XXIII.-E. P. B.; male; age 32 ; divorced ; 
clerk ; common school education. Intemperate habits. 
Born in New York. Heredity; father insane. Dura- 
tion of insanity probably between four and six months. 
Is now restless, noisy, very talkative; has delusions of 
the greatest wealth and importance; extremely emo- 
tional ; hesitates in speech ; tongue and lips tremulous; 
reflexes exaggerated. 
Hours. 
1.30 P.M 
1 st day. 
2d day. 
97-8 
3d day. 
98 
4th day. 
98 8 
5th day. 
98 8 
6th day. 7th day. 
98 
98.8 
3 3o " 
99 4 
98-4 
98.2 
98.2 
98 6 
98.6 
98.6 
5-30 " 
99 6 
99 2 
99 4 
98 6 
100 
99-4 
100 2 
7-30 " 
99 
99.8 
99 6 
98 4 
99 8 
98.8 
99-8 
9-30 
98.6 
99-2 
98.8 
98 
98.2 
98.8 
99 
11.30 " 
97-8 
99-4 
97 8 
98 
98 4 
98 4 
99-8 
1.30 A M. 
97-8 
98 8 
98 
97-8 
98.4 
97 8 
98.2 
3-3° " 
98.2 
97 8 
97-8 
97-6 
98 
98 
97 8 
5-3° " 
97-8 
97-8 
97-6 
97 8 
98 2 
98 2 
97 8 
7-3° " 
97 8 
98 6 
97-8 
97 8 
98 8 
97 8 
g8 2 
9-3° " 
97-8 
99 2 
98 4 
98 8 
99 2 
97 8 
97-8 
11.30 " 
97 8 
99-4 
98.2 
98.6 
98.2 
98.6 
97-8 
Widest daily 
variation. 
1.8 
2. 
2. 
1.2 
2. 
1.6 
2 4 
Case XXIV.-E. A. D. ; male ; age 48 ; married ; 
father of three children ; carpenter; common school 
education ; temperate habits but has had syphilis. 
Born in New York. Duration of insanity eighteen 
months. Has been exceedingly violent and excited, 
but is now becoming quieter and demented. Has de- 
lusions of the most enormous wealth and importance, 
e. g., that he is building houses and decorating them 
with diamonds, that he is sending many ships to Cali- 
fornia to be loaded with gold, etc., etc. Is now untidy 
and slovenly. Appetite enormous. Tongue, lips and 
fingers tremulous. Gait tottering and feeble. Both 20 
PARALYSIS OF THE INSANE. 
pupils are contracted and irregular, but unequal, r > 1 ; 
no patella reflex. 
Hours, 
ist day. 
2d day. 
3d dav. 
4th day. 
5th dav. 
6th dav. 
7th dav. 
I 45 P.M 
98 4 
98 2 
97-8 
98 8 
98 2 
98 8 
98.8 
3-45 
9S 
98 2 
98.6 
9S 
98.2 
98 8 
98.4 
5-45 " 
98.4 
98 2 
99 
98 2 
98 4 
99 
98.8 
7 45 " 
99 
98.2 
98.4 
9S 
98.4 
9s 4 
98 
9-45 " 
99 
98 
97 8 
99 
98. 8 
98.2 
98.8 
1145 *' 
98 
98 
98 
99 
98 2 
98.2 
98.4 
145 A.M. 
97-8 
98 
97 6 
98 
98.4 
98 
9§ 
3 45 
99 
97-8 
98 
9s-4 
9s 
98 
98 
5-45 " 
98.6 
97 8 
97-8 
97 8 
98 
98 
97-8 
7-45 " 
97-8 
98 
97.8 
97 8 
98 
98 
97-8 
9-45 
99 
98 4 
98 
98 
97-8 
98 2 
97 8 
n 45 " 
98.8 
98.8 
98.2 
97.8 
97 8 
98.6 
98.4 
- 
- 
- 
- 
- 
- 
- 
variation. 
I. 2 
I. 
1-4 
I 2 
I. 
I. 
I. 
Case XXV.-W. C. W.; male ; age 40 ; married ; six 
children ; machinist; common education. Intemperate 
habits. Born in New York. Duration of insanity be- 
tween two and three years. Is now very demented; 
happy. Has all the physical symptoms of the last 
stages of general paresis. About three weeks ago had a 
paretic attack, and has been in bed since, but is now 
rallying. Somewhat more paralyzed on the left side 
than on the right. Is very tremulous. Speech thick 
and indistinct; articulation difficult. Pupils irregular 
and unequal. Patella reflex exaggerated. 
Hours. 
ist day. 
2d day. 
3d day. 
4th day. 
5th day. 
6th dav. 
"th day. 
2 
P M. 
R 99.6 
R 98 2 
R 98 6 
R 98 f> 
R 98.6 
R 98 4 
L 99 4 
L 98 6 
L 98 4 
I. 98.2 
I. 98 3 
L 98.2 
4 
4 4 
R 98 8 
L 99 6 
6 
I . 
R 98 8 
R 98.8 
K 99 5 
R 98.6 
R 98 
R 98.4 
L 98 4 
L 98.8 
1- 99 5 
L 98 2 
1. 98.2 
L 98 2 
8 
4 » 
R 99 
L 98.8 
IO 
' » 
R 98.6 
R 98.2 
R 98.6 
K 97 8 
R 98. 7 
L 98 6 
1, 98.8 
L 97 9 
I. 98.6 
L 97.6 
12 
R 98.1 
L 97-8 
2 
A.M. 
R 98 2 
R 97.6 
R 98.2 
R 97.8 
R98.5 
L98 
I. 96 6 
1. 98.1 
1- 97-9 
L 98 3 
4 
4 4 
R97.8 
I - 97 6 
6 
* 4 
R 98.2 
R 97.8 
R 98.2 
R 98 2 
R 98.4 
L 98 
I. 97.8 
L 98 
I, 98 
L 98 2 
8 
4 4 
R 98 4 
L 98.2 
IO 
* 4 
R 98 8 
R 99.4 
R 98.2 
R 98 4 
R 98.4 
R 98 3 
I. 98 6 
L 98.6 
L 98.2 
I. 99 2 
I. 98.2 
I, 98.2 
12 
4 4 
R 99 
L 98.8 
Widest axillary variation - 4 
Average axillary variation = .18 As regards the average general bodily temperature 
of cases of general paresis, we have determined from this 
and previous studies that there is no variation from the 
normal. The following comparative table of tempera- 
tures in various forms of insanity made by one of us 
(L.), for the elder Seguin (" Medical Thermometry and 
Human Temperature," New York, 1876) shows that in 
acute mania only do we have any particular variation 
from the normal mean (slight hyperpyrexia): 
FREDERICK PETERSON. 
21 
Acute mania99.02 
Subacute mania98 66 
Chronic mania98.68 
Epileptic mania98.70 
Alcoholic Insanity98.70 
General paresis98.45 
Melancholia98 37 
Dementia 98.55 
The following table is derived from the thermometric 
observations in our twenty-five cases, and shows the 
greatest single diurnal oscillations noted on some one 
day, the average of such oscillations for one week, and 
the axillary variations in our ten cases : 
Cases. 
Greatest 
oscillation 
on a single 
day. 
A ver age 
daily oscil- 
lation for 
one week. 
Greatest , 
axillary 
asymmetry 
single ob- 
servation. 
Average 
axillary- 
variation 
for one 
week. 
I 
0 
I 2 
•9 
•15 
2 
I 8 
1.2 
8 
•24 
3 
2 4 
I I 
4 
2 4 
i-3 
1. 
•13 
5 
2.2 
1.1 
2.4 
. 22 
6 
6 
1.1 
1 8 
•34 
7 
2 6 
1-7 
8 
2 4 
i-3 
6 
. 16 
9 
1 4 
1 2 
IO 
3-4 
2- 2 
ii 
1.8 
12 
12 
2 2 
1-4 
13 
I. 
• 8 
• 
14 
2. 2 
I 2 
15 
3 
2. 2 
1.9 
• 23 
l6 
2 
I 4 
17 
3-8 
2. 2 
1 3 
.21 
18 
1 8 
I 2 
19 
2 4 
1-4 
20 
2.6 
1 5 
.6 
.16 
21 
2.4 
1 6 
22 
2 
1 5 
23 
2 4 
1 8 
24 
1-4 
1.1 
• 4 
.18 
Averages. 
2-3 
I 4 
1 17 
. 20 22 
PAR AL YSIS OF THE INSANE. 
That there are marked oscillations of temperature 
will be seen in an examination of the table. These sin- 
gle day oscillations are quite marked, in cases ten and 
seventeen as high as 3.4 and 3.8 degrees. But it is per- 
haps fairer to contrast the average daily oscillation for 
the week in each case with the normal. Now Ogle 
gives the normal diurnal oscillation as 1.50'Falir., and Al- 
varenga, Barensprung, Jurgensen, Jager and Huguenin 
place the figure at even more,--upwards of 20 Fahr. 
The lowest average diurnal oscillation in any one of our 
cases of general paresis was .8° ; the highest, 2.20. The 
total average for all of the cases was 1.4, which we may 
consider, therefore, as not at all deviating from the nor 
mal. The following table will make the observations as 
to diurnal oscillations more clear: 
No. of Cases. 
Average daily oscilla- 
tion for one week. 
Ill I Case. 
8 
" 4 " 
1.1 
" 6 " 
1.2 
"2 " 
i-3 
" 3 " 
14 
"2 " 
1 5 
" 1 " 
1.6 
I J li 
r-7 
<. J <<. 
. I 8 
" 3 " 
2.2 
"24 " 
average 1 4 
The axillary temperatures of the two sides were 
taken simultaneously. The smallest average axillary 
asymmetry was .13°, the greatest .34, but among single 
observations there were many instances of exact corre- 
spondence ; while in one case, one observation showed a 
difference of 2.40. The mean of greatest single axillary 
deviations in the ten cases was 1.17. We have been un- 
able to find tables of normal axillary asymmetry, and 
thus cannot contrast our measurements with physiologi- 
cal tables, but it is a fact that under normal conditions 
there are variations between the two sides of the body; 
and as regards the head, for instance, the differences 
noted by various observers have been fully as appreciable 
as these observations of ours in the axillae of paretics. 
There is then no good reason for supposing that there 
are remarkable and abnormal differences in axillary 
temperatures in paretics. FREDERICK PETERSON. 
23 
We would sum up our conclusions, after careful in- 
vestigation of the bodily temperatures of paretics, as 
follows: 
1. As regards the average bodily temperature, we 
find it to correspond to physiological normes. The 
statements of our predecessors as to hyperpyrexic or 
subnormal averages cannot be sustained. 
2. The diurnal oscillations of temperature in paretics 
also correspond to physiological normes. The state- 
ments to be found in literature as to extraordinary 
daily variations being frequent in these cases are ab- 
solutely erroneous. 
3. Asymmetrical axillary differences are so small 
that they cannot be considered as abnormal, and cer- 
tainly not of any diagnostic significance. 
4. When unusual variations of temperature occur in 
general paretics, their cause must be sought for in con- 
ditions not related to the pathological phenomena of 
paralytic dementia, but depending upon thermogenic 
features unrecognized by the physician, or " masked " by 
the mental state of the patient. Thus, in case two of 
our series, an increasing hyperpyrexia was noted during 
the second week's observations, but the pneumonia 
causing it was " masked " until the fifth or sixth day, 
the patient dying on the sixth day. Again in case ten, 
where the highest single daily oscillation was 3.40 and the 
average daily oscillation for the week 2.20, the patient 
suffered from bed-sores which undoubtedly produced 
some septicaemia. That variations of temperature may 
take place in connection with the paralytic and convul- 
sive seizures of these cases we do not gainsay, but have 
made no observations under such circumstances. THE ALLIANCE PRESS, 
Successors to Raff & Co., 
134 & 136 West 26th Street, 
NEW YORK.